The invention is directed to an arrangement for the elimination of substances from fluids in particular blood which comprises in the first circuit wherein the fluid to be treated flows, an attachable membrane filter and in whose secondary, for example, filtrate side there is a suspension containing an adsorbent for binding those substances passing through the membrane.
The elimination of patho-physiologically relevant substances can be carried out with extra corporeal systems, wherein membrane filters and adsorption procedures may be utilized. Included in such processes there may particularly be mentioned hemodialysis, high-flux hemodialysis, hemofiltration, membrane plasma separation, hemoperfusion and plasma perfusion. For special purposes, for example, the therapy of liver failure, hybrid systems which comprise the provision of special cell types such as hepatocytes, are in clinical trial. For example, such therapeutic procedures are utilized for chronic kidney insufficiency, acute exogenic intoxication, acute and chronic liver insufficiency, endotoxin shock, metabolic disturbances, hyperlipidemia, and auto immune diseases. With respect to the presently known pathophysiologically relevant substances, one is concerned with a substantial spectrum of different substances having different chemical (protein-lipid-waterbound, hydrophilic, hydrophobic) and different physical properties (molecular size, molecular weight) for which reason different procedures must be utilized.